AB1145 QUALITY INDICATORS: APPLYING QUALITY MEASURES TO IMPROVE SERVICES AND PATIENT OUTCOMES. A QUALITY IMPROVEMENT INITIATIVE
Authors: Y. El Miedany, M. H. Abu-Zaid, M. Elwy, S. A. Mahran, A. Elyasaki, M. Elgaafary, W. Hassan, W. Elwakil, S. Saber, S. A. A. Tabra
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The use of quality-of-care indicators is an important strategy to measure and evaluate if the care provided in the standard clinical setting adheres to current evidence informed best practices. Achievement of quality indicators is often reported as a quality score (%). Quality indicators are often developed from guidelines, systematic literature reviews, or expert panel consensus using a systematic approach. The recently developed national guidelines for inflammatory arthritis [1, 2] provided the fundamentals of quality indicators of inflammatory arthritis. <h3>Objectives</h3> To evaluate quality indicators for inflammatory, their use in routine clinical practice reflecting the processes of clinical care and improvement in outcomes. <h3>Methods</h3> Quality measurement was carried out across 5 centers based on six domains of quality: 1. Structure (Describes the innate characteristics of providers and the system and the organisational aspects of care), 2. Process (Assesses actual healthcare service delivered to patients by healthcare providers), 3. Patient experience (Describes the patient's perception of quality of care)[3], 4. Outcome (Assesses the end result or the final goals of the delivered care), 5. Access (Evaluates the provision of timely and appropriate healthcare), 6. Efficiency (Describes the relationship between clinical performance and resource use). Data were logged based on patients' recorded data. <h3>Results</h3> Inflammatory arthritis services are provided in 100% of the centers. 88.3% of the participants voted that they do implement "Treat to Target" approach and quality indicators for the management of inflammatory arthritis in their standard practice. Patient experience was rated positive in 63% whereas Timely treatment target was recorded in 74%. Efficiency evaluation revealed constrains attributed to lack of insurance cover of cost of some recommendations (72.7%). <h3>Conclusion</h3> Irrespective of resource and infrastructure constraints, assessment of all the relevant domains of care, revealed improvement and strengths of all the other measures. Results revealed that the treating rheumatologists not only do adhere to quality indicators required for the management of inflammatory arthritis, but also provide timely and appropriate healthcare that has been well received by the patients. Such results are vital as quality measurement in rheumatology is focused primarily on processes of care, consequently, process measurement facilitates implementing actionable targets for improvement instead of focussing solely on outcomes of care. <h3>References</h3> [1]El Miedany Y et al. Egyptian guidelines for the treatment of Rheumatoid Arthritis — 2022 update. Egypt Rheumatol Rehabil 2022; 49: 56. [2]El Miedany, Y, N. et al. Psoriatic arthritis treatment to the target: a consensus, evidence-based clinical practice recommendations for the management of psoriatic arthritis and its concomitant clinical manifestations. Egypt Rheumatol Rehabil 2022; 49: 32. [3]Miedany YE et al. Patient Reported Experience Measures (PREMs) as a quality tool. Clin Exp Rheumatol 2014; 32:547–52. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.